Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $19,498.45	Facility		$1,047.13	$1,047.13	$19,498.45
Molina Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,174.90 / $2,398.83	Facility		$1,148.15	$1,174.90	$2,398.83
Quartz Facility/Professional Facility Modifier Low / Median / High Price $13,803.84 / $13,803.84 / $13,803.84	Facility		$13,803.84	$13,803.84	$13,803.84